Individual
AUDREY KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.C.B.A
Contact information
Practice address
4000 S YORKTOWN WAY, BOISE, ID 83706-6036
(301) 514-4415
Mailing address
4000 S YORKTOWN WAY, BOISE, ID 83706-6036
(301) 514-4415
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0133000003
VA
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/02/2013
Last updated
01/24/2019
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